Rights at heart of drugs health programme

The Drug Intravenous Organisation (better known as Divo) is a nonprofit organisation working under the Ministry of Health and is one of about 20 specialist outlets in New Zealand selling new needles and syringes to drug users as part of a national needle exchange programme.

It aims to reduce the transmission of blood-borne viruses and infection rates by safely disposing of used needles and syringes, and providing clean equipment.

Divo also offers information and advice about preventing the transmission of blood-borne diseases as well as drug addiction, safe sex and other health issues.

As part of a harm-reduction initiative, Divo and other outlets eliminate the need for drug users to share needles and syringes, or reuse equipment.

From 2004, users have been able to swap a used needle or syringe for a free new one at Divo and other outlets.

New units cost about $1 on average.

Divo is confidential and anonymous, and protected from government or police scrutiny by privacy and health confidentiality legislation.

Manager Barb Smith says Divo is nationally unique because it also offers a free weekly GP clinic and blood testing.

The outlet is also undertaking a trial of an on-site alcohol and drug addiction counsellor.

Mrs Smith says staff do not condone illegal drug use but accept it will continue, and endeavour to treat those who use the service without judgement.

"It is about demystifying drug use. We operate with respect and in the belief that human rights apply to everyone."

She says many people with drug issues are unwilling or unable to get treatment, and there is a need to provide options that minimise risk while protecting their rights.

To make users feel secure, people with personal experiences of drug use are employed.

The peer-service model means staff can understand drug issues and provide empathy.

"This has been essential in developing ongoing relationships in an often hidden and hard-to-reach population," Mrs Smith said.

In Dunedin, the majority of those who inject drugs are European males aged 35 years or older.

Prescription opioids including methadone and oxycontin (oxycodone) are the most commonly injected drugs in Dunedin, although ritalin is also widely used.

Mrs Smith cannot say how many people use Divo, to ensure those who do feel protected, but she says the outlet has a "very regular" clientele.


Sharp end

An estimated 60%-70% of injecting drug users in New Zealand have hepatitis C.

Needle exchange sales have grown rapidly since 1994 and the proportion of used needles and syringes returned for destruction has risen from a national average of 26% to about 90%.

New Zealand has one of the lowest HIV infection rates among injecting drug users in the OECD: about 0.5%.

As at 2006, national distribution of injecting equipment exceeded 2 million units per annum, double the figure pre-2004 when the free swap initiative was implemented.